PHTLS Qs from Exam 5 & 6 Questions and answers

When caring for a trauma patient, a principle is what is necessary for patient improvement or survival. A preference is how the principle is achieved and depends upon four factors. The factors used to establish the preference in treating the patient include all except: a) Condition of the patient b) Equipment available c) Situation that exists d) Research information d) Research information Approximately 20% of all child abuse is the result of intentional burning. The majority of the children intentionally burned are of what age? a) 10 to 12 years of age b) 5 to 6 years of age c) 1 to 2 years of age d) Less than 1 year of age. c) 1 to 2 years of age You are called to treat a patient who was knocked unconscious when he slipped and fell on a wet floor, striking his head. It is now several hours later. He is awake but confused, does not recall the incident, and is vomiting with a headache. Which of the following injuries is most likely? a) Brain herniation b) Intraabdominal hemorrhage c) Diffuse axonal injury d) Concussion. d) Concussion. When using a selective spinal immobilization protocol, which of the following findings indicate the need for immobilization? a) Past history of spinal injury b) Being an unrestrained passenger in a motor vehicle crash c) Being ambulatory at the scene d) An associated femoral shaft fracture with severe pain d) An associated femoral shaft fracture with severe pain A patient presents with a blunt trauma injury to the chest. On exam, he has absent breath sounds on one side of his chest and respiratory distress. Which additional sign would indicate that the patient has a tension pneumothorax? a) Distended neck veins b) Inspiratory wheezing c) narrowed pulse pressure d) Tracheal deviation towards the side of injury a) Distended neck veins Hemostatic agents should be used for excessive bleeding when direct pressure alone does not work. The proper way to use most hemostatic agents is which of the following? a) Placing the agent around the edges of the wound b) Placing the agent properly into the wound and holding direct pressure c) Only using it after a tourniquet has been applied for 10 minutes d) Hemostatic agents should never be used unless you have a fall in blood pressure b) Placing the agent properly into the wound and holding direct pressure Excessive fluid resuscitation of the trauma patient can result in which of the following? a) Worsening coagulopathy b) Decreased mortality c) Earlier discharge from the hospital d) A higher incidence of sepsis in the ICU a) Worsening coagulopathy In a blast-related multiple patient situation, which of the following patients should be treated first? a) A 33-year-old female with altered level of consciousness and decreased capillary refill b) A 28-year-old male with an arm amputation who has bleeding controlled with a tourniquet c) A 14-year-old pulseless female with grey matter visible from a head wound d) a 78-year-old male awake and unable to hear a) A 33-year-old female with altered level of consciousness and decreased capillary refill When approaching a trauma patient, what is the first assessment that must be made? a) Exsanguinating hemorrhage b) Scene safety c) Airway d) Breathing b) Scene safety Which of the following best guides the decision to provide spinal immobilization? a) History and complaint b) Obvious signs of associated injury c) Patient's age and presence of pressure sores d) Mechanism alone a) History and complaint A 38-year-old male sustains a large wound to his right thigh while at work. Which of the following actions is the most important initial step? a) Obtain IV access and infuse crystalloid b) Administer supplemental oxygen c) Hemorrhage control d) Rapid transport c) Hemorrhage control The pre-hospital assessment of the trauma patient begins with which of the following? a) Assessment of scene safety and situation b) Information provided by the dispatcher c) The initial assessment d) The primary survey b) Information provided by the dispatcher Which of the following is the best indicator of shock in a trauma patient? a) Depressed level of cognition b) Heart rate of 80 c) Respirations of 18 d) GCS of 15 a) Depressed level of cognition You respond to a local bar for an unconscious person. On arrival, you are met by a police officer who reports that one of their "regular alcoholics" was found in the alley behind the bar. On exam, you note the smell of an alcoholic beverage as well as the following: Patient flexes his arms to painful stimuli, has bilateral fixed and dilated pupils, irregular respirations at 12 breaths per minute and a BP of 210/100. What condition do you suspect? a) Subarachnoid hemorrhage b) Alcohol poisoning c) Ruptured abdominal aortic aneurysm d) Subdural hematoma d) Subdural hematoma Hypotension due to a spinal cord injury is a result of what physiological mechanism? a) Loss of sympathetic tone causing vasodilation b) Increased capillary permeability c) Increased sympathetic tone causing vasoconstriction d) Increased intrathoracic pressure a) Loss of sympathetic tone causing vasodilation